Association between plasma homocysteine and hypertension: Results from a cross-sectional and longitudinal analysis in Beijing's adult population from 2012 to 2017

Dietary intake of methyl donor nutrients in relation to metabolic health status, serum levels of brain-derived neurotrophic factor and adropin

BACKGROUND AND AIMS

There is a lack of evidence on dietary intake of methyl donor nutrients with metabolic health status and related biomarkers. Thus, this study aimed to assess the relation between methyl donor nutrients intake and metabolic health status with regarding the interactive roles of brain-derived neurotrophic factor (BDNF) and adropin in Iranian adults.

METHODS

This cross-sectional survey was conducted among 527 Iranian adults (45.7% female) selected by multistage cluster random-sampling method. A validated food frequency questionnaire was used to evaluate participants' dietary intake. Metabolic unhealthy status was defined by Wildman criteria as having ≥ 2 of hyperglycemia, hypertriglyceridemia, hypo-HDL-cholesterolemia, hypertension, chronic inflammation, and insulin resistance. Concentrations of metabolic parameters, BDNF and adropin were determined using fasting blood samples.

RESULTS

An inverse association was found between methyl donor nutrients intake and metabolically unhealthy status in multivariable-adjusted model (ORT3 vs. T1 = 0.30; 95%CI: 0.12-0.75). This association was especially significant among overweight/obese adults and was stronger in women. Additionally, consumption of vitamin B6 and choline was separately related to reduced odds of metabolically unhealthy status. Methyl donor intake was not significantly related to low BDNF (ORT3 vs. T1 = 0.93; 95%CI: 0.60-1.44) and adropin (ORT3 vs. T1 = 0.71; 95%CI: 0.44-1.15). However, the interaction between high methyl donor nutrients intake and high BDNF was related to lower odds of metabolically unhealthy status in multivariable-adjusted model (ORMDNS∗BDNF = 0.27; 95%CI: 0.11-0.67).

CONCLUSION

Higher intake of methyl donor nutrients, alone and in interaction with BDNF levels, was associated with decreased odds of metabolically unhealthy status in Iranian adults.

Preliminary Consequences of Blood Pressure Management and Blood Homocysteine Levels with Perindopril in Newly Diagnosed Hypertensive Patients in the Vietnamese Population

Background

Perindopril is an ACE inhibitor that aids in both blood pressure regulation and homocysteine reduction.

Objectives

Our study aimed to evaluate the results of controlling blood pressure and blood homocysteine levels by perindopril in patients with primary hypertension.

Materials and Methods

A cross-sectional descriptive study with a longitudinal follow-up was conducted on 105 primary hypertensive patients treated with perindopril.

Results

The results of our study showed that after 6 weeks of treatment with perindopril, the proportion of patients with the target blood pressure (BP) level accounted for 70.5%, the rate of grade 1 hypertension decreased from 61.0% to 25.7%, grade 2 blood pressure decreased from 17.1% to 3.8%, and there was no case of grade 3 hypertension. At the same time, we also found that the rate of BP control in the group of patients who controlled Hcy below a threshold of 15 μmol/L was significantly higher than in the other group (p  <  0.05). Concerning the efficacy of decreasing homocysteine in blood, we discovered that after 6 weeks of treatment with perindopril, the proportion of patients with elevated homocysteine reduced considerably from 74.3% to 40% (p  <  0.05). In addition, the homocysteine concentration was 4.33 mol/L lower after treatment than before treatment (95% CI: 3.69-4.97) (p  <  0.05).

Conclusion

Perindopril helps control blood pressure and reduces blood homocysteine levels in patients with primary hypertension.

Association between methyl donor nutrients and metabolic health status in overweight and obese adolescents

Limited evidence is available regarding the association of methyl donor nutrients and adolescents' metabolic health. Therefore, we investigated the relation between a combination of methyl donor nutrients and metabolic health status of overweight and obese Iranian adolescents. In this cross-sectional study, 203 overweight/obese adolescents were included, using a multistage cluster random-sampling method. Dietary intakes were assessed by a validated food frequency questionnaire. Methyl donor nutrient score (MDNS) was constructed based on deciles of vitamins B2, B6, B9, B12, methionine, choline and betaine. Glycemic profile, lipid profile, blood pressure and anthropometric indices were collected. Participants were classified as metabolically healthy obese or unhealthy obese (MUO) based on International Diabetes Federation (IDF) and IDF/Homeostasis Model Assessment Insulin Resistance (HOMA-IR) definitions. Mean age of adolescents was 13.98 [Formula: see text] 1.61 y and 50.2% of them was girls. After controlling all of the confounders, individuals in the top tertile of MDNS, had lower odds of MUO (OR 0.36; 95% CI 0.13-0.95) according to IFD criteria. Considering IDF/HOMA-IR criteria, an inverse marginally significant association was observed between the highest tertile of MDNS and odds of MUO (OR 0.36; 95% CI 0.12-1.02) in the fully-adjusted model. Furthermore, significant inverse association was found between each unit increase in MDNS and odds of MUO based on IDF criteria, but not for IDF/HOMA-IR definition. We found that overweight/obese adolescents with higher dietary intakes of methyl donor nutrients were less likely to be metabolically unhealthy. Further studies are needed to confirm the findings.

The significance of homocysteine in patients with hypertension

Cardiovascular disease is the most common cause of death in developed countries. Important factors leading to ischemic heart disease and strokes are hypertension and high levels of homocysteine in blood serum. The coexistence of these two factors significantly increases the risk of these diseases and premature deaths. Many studies indicate that patients with hypertension are significantly more likely to demonstrate increased blood serum homocysteine levels than those with normal blood pressure. This may be caused by a higher incidence of overweight, high intake of salt and increased uric acid levels. It has been shown that both these factors increase the prevalence of hypertension and lead to higher homocysteine levels. However, the results of some studies indicate that arterial hypertension and homocysteinemia are causally related. It was shown, among other things, that high homocysteine levels damage the endothelium and reduce nitric oxide synthesis, which may directly lead to hypertension. Serum homocysteine levels are slightly higher in patients with white coat hypertension than they are in healthy individuals and may therefore also increase the risk of cardiovascular diseases. Several authors have also shown that the levels of homocysteine in blood serum are higher in so-called non-dippers, i.e., patients with no night-time pressure drop. The lack of a 10%–20% decrease in blood pressure at night is associated with increased cardiovascular complications. Strokes occur especially frequently in older people with arterial hypertension and hyperhomocysteinemia. The administration of B vitamins and folic acid significantly reduces serum homocysteine levels. The administration of this acid also slightly, but statistically significantly, increases the effectiveness of hypotensive drugs. Large meta-analyses meta-analysis indicate that the increased supply of folic acid in patients with hypertension significantly reduces the risk of stroke. Such management is particularly effective in patients with hypertension and hyperhomocysteinemia.

Hypertension-Mediated Organ Damage Correlates With Serum Homocysteine Level in Community-Dwelling Elderly Chinese: The North Shanghai Study

Introduction: Serum homocysteine (Hcy) level is associated with cardiocerebrovascular disease. However, the relationship between Hcy and hypertension-mediated organ damage (HMOD) in non-hospitalized residents has not been elucidated. We aimed to investigate the association of HMOD with Hcy in elderly Chinese.

Methods: One thousand seven hundred and forty-four community-dwelling elderly Chinese (age ≥65 years) participated in the Northern Shanghai Study from Jun. 2014 to Aug. 2015. Hyperhomocysteinemia (HHcy) was defined as serum Hcy ≥15 mmol/L, and HMOD was estimated as arterial stiffness [carotid-femoral pulse wave velocity (CF-PWV) and ankle-brachial index (ABI)], cardiac impairment [left ventricular (LV) hypertrophy and LV diastolic dysfunction], and renal dysfunction [estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio]. Linear and logistic regression models were built to explore the associations of HMOD with Hcy.

Results: Among 1,744 participants, 632 (36.2%) were diagnosed as HHcy. HHcy group had more men (61.2 vs. 35.3%), with higher age (73.7 ± 6.7 vs. 70.4 ± 5.3 years) and BMI (24.2 ± 3.4 vs. 23.7 ± 3.5 kg/m²). Linear regression analysis showed that serum Hcy level was positively associated CF-PWV and negatively associated with ABI and eGFR. By logistic regression, HHcy was significantly associated with abnormal CF-PWV [odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.08–2.16] and ABI (OR = 1.55, 95% CI 1.17–2.04), and decreased eGFR (OR = 7.09, 95% CI 4.03–12.47) after adjustment for covariates. Moreover, similar associations of serum Hcy level with CF-PWV and eGFR were observed in subgroups by gender and hypertensive state.

Conclusion: HMOD, particularly renal dysfunction and arterial stiffening, was significantly and independently associated with increased serum Hcy level in the elderly Chinese.

Clinical Trial Registration: [ClinicalTrial.gov], identifier [NCT02368938].

Associations of global DNA methylation and homocysteine levels with abdominal aortic aneurysm: A cohort study from a population-based screening program in Sweden

Abdominal aortic aneurysm (AAA) is a life-threatening condition with a mortality rate of over 80%. Persistent smoking, which is a risk factor for AAA, has lasting effects on DNA methylation. Moreover, a plasma-amino acid, homocysteine, previously implicated in vascular diseases, including aneurysms, has well-established biological association with methylation. In the present study, we aimed to determine the global DNA methylation, homocysteine levels and their association with AAA and its growth. Enzyme-linked immunosorbent assay (ELISA) was used to quantify global DNA methylation in whole blood-DNA samples and diagnostic enzymatic assay quantified plasma homocysteine, from 65-year old men with (n = 116) and without AAA (n = 230) diagnosed at ultrasound screening. We found significantly higher global DNA methylation (p < .001) and homocysteine levels (p < .001) in men with AAA compared to those without AAA, and direct linear associations with baseline aortic diameter. On multivariable regression analysis, global DNA methylation (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.1-2.9) and homocysteine levels (OR: 1.1; 95% CI:1.0-1.1) were positively associated with AAA, independent of smoking, medication use, and major co-morbidities. However, we did not find any significant association between DNA methylation or homocysteine levels with AAA growth during follow-up. We found that global DNA methylation and homocysteine levels are higher in men with AAA but are not associated with AAA growth. This indicates that different pathways and mechanisms may be involved in initiation and progression of AAA. More studies are needed to understand the precise role of DNA methylation, homocysteine and their interplay in AAA pathophysiology.

Homocysteine level is positively and independently associated with serum creatinine and urea nitrogen levels in old male patients with hypertension

A cross-sectional study to show whether and how serum fasting homocysteine levels are associated with renal function changes in patients with hypertension. Homocysteine levels were associated with serum creatinine and blood urea nitrogen (BUN) levels with coefficients of 2.04 and 0.07, respectively, only in males and independent of confounders. In addition, low density lipoprotein cholesterol (LDL-C) levels were positively and left ventricular ejection fraction (LVEF) was negatively associated with serum creatinine level in males; age was positively associated with serum creatinine levels in females. Age was a common risk factor positively associated with BUN levels in both sexes, while total cholesterol (TC) levels and glycemic control were independent risk factors that were positively associated with BUN levels only in males. LDL-C levels and LVEF were negatively associated with BUN levels in females. Body mass index (BMI) was positively associated and hemoglobin A1c (HbA1c) levels, high density lipoprotein cholesterol (HDL-C) levels and the presence of stroke were negatively associated with serum uric acid levels in male patients. In contrast, only LVEF was positively associated with uric acid levels in females. In conclusion, homocysteine level is an independent risk factor associated with serum creatinine and BUN levels in male patients with hypertension.